Document Type: Original Article

Authors

1 Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan.

2 Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan.

3 Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan

4 Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan

Abstract

Background: Lead toxicity continues to remain a concerning health problem for developing nations like Pakistan. Due to a lack of studies, we aim to highlight the clinical spectrum of lead poisoning in patients presenting to an urban based tertiary care hospital in Pakistan.

Method: This is a retrospective review of patients admitted form January 2011 to December 2014 using a structured questionnaire for recording demographics, comorbidities, clinical findings, biochemical abnormalities, clinical findings and treatment provided. Patients were categorized as children (≤18yrs) and adults (>18yrs), patients were further divided into three groups; desired Blood lead levels (BLLs) [lead levels 70ug/dl].

Result: A total 86 patients were included in final analysis, majority (69.6%) were adult males with median age of 35 yrs. Median (IQR) BLL was 6.3 ug/dl (12.8-2.7) in all age groups with BLL in children and adults of 4.2ug/dl (3.1-5.7) and 6.5ug/dl (2.6-14.7) respectively. 72% of children had complaints related to the central nervous system with majority complaining of irritability. The gastrointestinal system was most commonly implicated in adults (93%) with most common complaint of abdominal pain. Commonest risk factors showing a positive correlation with BLLs was battery handling in adults [median (IQR) BLL 18.4ug/dl (8.35-36.1)] and pica eating in children with BLLs in high but non-toxic range [median (IQR) BLL 5.2ug/dl (2.7-5.7)]. Highest BLLs were observed to lie within the high but non-toxic range group in one adult herbal medicine user (54.4 ug/dl) and in children were observed in the toxic range group (>10ug/dl) due to occupational battery work exposure and residence in a congested zone.

Conclusion: Lead toxicity continues to be hazardous due to unchecked environmental and occupational exposure. Increasing awareness is tantamount in order to find a solution.

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